Delusion or reality?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.


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Sometimes delusions get people into trouble.

One problem area for mental health is distinguishing between delusions and reality. If

something is highly unlikely and yet despite mounds of evidence that can’t be true, that someone still firmly believes in its truth, it’s likely to be a delusion. Unfortunately, one person’s belief may be another person’s delusion. Disagreements about the truth often result in violence. After there’s been a violent incident, the question often arises why hadn’t someone spotted that person who was likely to become violent?

Identifying when someone is delusional is the first step. Figuring out when that delusion will lead that person to violence is a much more difficult task.

Defining delusions.

The technical definition of delusions is fixed beliefs which people are unwilling to change even when presented with evidence to the contrary. The harder it is to tell what is truth and what is delusion, the more likely it is to result in violence. Religion and politics are two areas particularly prone to disagreements that lead to violence.

Here’s a list of the recognized themes of delusions.

  1. Someone’s out to get me, technically called persecutory delusions.
  2. Grandiose delusions, the person believes they are special and have exceptional abilities.
  3. Love and sex delusions are technically called erotomanic delusions, during which the delusional person believes someone is in love with them or wants them sexually.
  4. Nihilistic delusions involve the fixed belief that a major disaster will occur.
  5. Delusions regarding health and body functioning are called somatic delusions.

Is that delusion bizarre?

When other people in your culture don’t believe, something could happen, it would not be a normal experience for them. Common examples of beliefs that would be considered bizarre delusions include the idea that someone is beaming thoughts into your head or removing your thoughts. Some people also believe that an outside force is controlling them.

The problem with diagnosing delusions.

Delusions can occur in the course of several mental illnesses. There is also one specific category titled Delusional Disorder (F-22) which is a catchall for several distinct kinds of delusions which occur outside the course of another mental illness.

One type of delusion which results in a lot of problematic behavior is the delusional form of jealousy. Jealousy is a complicated topic; not all jealousy is delusional. But delusional jealousy, sometimes described as morbid or pathological jealousy, can result in stalking and interpersonal violence.

In upcoming blog posts, we will look at delusional disorder and then some of the varieties of jealous behavior, when is jealousy good for relationships, as well as how and when jealousy becomes dangerous.

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

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Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

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